Publication - FOI/EIR release

Impact of Brexit on Health and Social Care: FOI release

Published: 12 September 2017
Directorate: Health Workforce Directorate
Topic: Health and social care, Public sector

Information request and response under the Freedom of Information (Scotland) Act 2002.

FOI reference: FOI/17/01830
Date received: 10 August 2017
Date responded: 6 September 2017

Information requested

1. Any written assessment of the effects of leaving (a) European Union (b) the European Medicines Agency (c) Euratom on (i) the Scottish NHS (ii) the Scottish NHS workforce (iii) Scottish patient access to medicines and treatments;

2. Written records of any communications within the last six months between Health and Social Care Directorate and (a) the Strategy and Constitution Directorate (b) any NHS Scotland Board (c) any other Directorate of the Scottish Government (d) any Ministry of the UK Government (e) the UK Permanent Representation to the EU on the impact of leaving the European Union on the NHS workforce;

3. Any written impact assessment, assessment, situation analysis, risk register or similar document produced by (a) the UK Government (b) the Scottish Government (including the Directorate) (c) a third party on the effects of leaving the European Union on the NHS workforce;

4. Information on the number of NHS Scotland staff who are (a) are non-UK citizens (b) are non-UK EU citizens (c) are non-UK non-EU citizens.

Response

With regard to your request, while our aim is to provide information whenever possible, in this instance the Scottish Government does not have all of the information you have requested. The reason why some of the information is not available is because, to date, the Health and Social Care Directorates have not completed any written assessments of the effects of leaving (a) European Union (b) the European Medicines Agency (c) Euratom on (i) the Scottish NHS (ii) the Scottish NHS workforce (iii) Scottish patient access to medicines and treatments.

The reasons for this are that (a) the terms of leaving the European Union have not yet been negotiated or agreed; (b) there has been no requirement for NHS Boards to collect nationality data for their staff, comprehensive nationality data on the staff working in the NHS is not available; and (c) issues relating to the European Medicines Agency and access to medicines are dependent upon legislation reserved to the UK Parliament.

However, the Scottish Government is extremely concerned at the impact of leaving the EU, and in particular of ending the freedom of movement on the workforce in Scotland, and work to address the NHS workforce data issue is underway but we cannot provide the information you requested at this time. Therefore, for these parts of your request, a formal notice under section 17 (1) of FOISA has been applied as some of the information you have requested is not available.

With regard to the effects of leaving the European Medicines Agency, enclosed is a copy of a letter from the Cabinet Secretary for Health and Sport to Jeremy Hunt, UK Secretary of State for Health seeking clarification on the UK's future relationship or membership.

It is important to emphasise that licensing, safety and efficacy of medicines is reserved to the UK Government and is the responsibility of the Medicines and Healthcare products Regulatory Agency (MHRA) who operate on a UK wide basis. It is the Scottish Government's view that the reserved matters are the most likely to impact on access to medicines and treatments in Scotland and the wider UK.

Securing access to medicines and treatments for Scottish patients is of the highest priority to the Scottish Government. The devolved administrations have been working with the UK Government on the Health Service Medical Supplies (Costs) Act 2017, the supporting regulations for which are now being consulted upon – see the below web links. Whilst the main emphasis of the Act is about measures to control medicines costs and deliver value for money for the NHS, a key feature are the Secretary of State's powers to help ensure adequate supplies of health service products for NHS patients:

Through the proposed regulations, this will require manufacturers and wholesalers to give up to 6 months advance notice of any anticipated discontinuations of supply, or supply disruptions, so that co-ordination and management can be implemented to mitigate/minimise the impact on patient care. In more extreme cases, the proposed regulations would require this information within 24 hours together with amounts of stock available as well as advising on therapeutic alternatives.

A memorandum of understanding will be developed between the Secretary of State and equivalent Ministers in the Welsh, Scottish and Northern Ireland Governments underpinning the collaboration of information provision and the disclosure of information.

Health Service Products

Control Cost Of Branded Medicines

In relation to the other parts of your request, we are unable to provide some of the information you have requested because of exceptions that have been applied under sections 28(1), 29(1)(a), (b) and(c) relating to relations with the UK and the formulation or development of government policy and Ministerial communications and under section 30(b)(i) which allows for the free and frank exchange of advice. The reasons why these exemptions apply are explained below.

For the number of NHSScotland staff who are (a) non-UK citizens (b) non-UK EU citizens and (c) non-UK non-EU citizens, due to the lack of comprehensive data available, the main source of data we use is the Annual Population Survey (APS). The APS combines results from the Labour Force Survey (LFS) and is a household survey of people in the UK. Its purpose is to provide information on the UK labour market and it also includes data such as country of birth and nationality. Further information on the APS can be found at Annual Population Survey. We also use data published by the General Medical Council (GMC). Further information at the GMC website can be found at Data on EEA Doctors.

In relation to the information that is available, I have enclosed the relevant information in the table attached below.

In terms of other points of information that you might find helpful, Scottish Ministers continue to update the Scottish Parliament regularly as the UK's negotiations to leave the EU progress. Further information on the work being conducted by the Scottish Government can be found at EU Referendum.

You may also be interested to view the briefing notes available on the Scottish Parliament website at Parliament Briefing which provide a range of SPICe briefing papers in relation to the UK's negotiations to leave the EU.

For NHS workforce data, National Services Scotland Information Services Division (ISD) publish a range of NHS workforce data that you might also find helpful. Further information on this can be found at NHS Workforce Data.

Reasons for not providing information

Exemptions applied, subject to the public interest test.

Exemptions under section 28 (1), 29(1)(a), (b) and (c) and section 30(b)(i) of FOISA applies to some of the information you have requested.

These exemptions are subject to the 'public interest test'. Therefore, taking account of all the circumstances of this case, we have considered if the public interest in disclosing the information outweighs the public interest in applying the exemption. We have found that, on balance, the public interest lies in favour of upholding the exemption. We recognise that there is a public interest disclosing information as part of open, transparent and accountable government, and to inform public debate and discussion on the potential impact that leaving the European Union will have on the people in Scotland and indeed on the NHS Workforce. However, this is outweighed by the public interest for upholding application of exemption.

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at http://www.gov.scot/foi-responses